The URL can be used to link to this page

Home My WebLink About22281-zTOWN OF $OUTHOLD BUILDING DEPARTMENT TOWN HALL $OUTHOLD, N.Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) Da,e ................................. ,~..~ ................ 22281 Z Permission Is hereby granted to: ......... ~..~..~.~~...-. ......... :ZY..:..~, to ~' ~"~ ....... ~,~.~.~.........~ ....... ~?..~..~ ....... ~~....~....~ ....................... ........ ~ ........... ~.~k ....... z~....~..~.~..,~.~.~ ,.~ ....... ~ ......... ~.~ ........ ~¢/ .............. ~ ............................................................ at premises located a ......................................................................... ............................................ /~.'.'./z¢. ~ ~/~,~/.. .......... ~..~. ............................ .~ ....... CounlyTax Map No. 1000 Sec,ion ........ ..~...~ ....... Book ........ ~ ...........Lot No...~....~ ............. (-"¢--' ~ 7L "'~-...~,19 and pursuant to application dated ............. ~ .......¢ .......................... ~ ....... approved bythe Building Inspector. Fee $.,,.'~,,,.,,~,,, ............. Rev. 6/$0/80 BLDG. DEPT. TOWN OF SOU'[HOLD .......... .......... I. Disapproved~ a~c ...... ~ ......................... FORM NO. 1 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN tlALL SOUTIIOLD, N.Y. 11971 (Building Inspector)~' :ATION FOR BUILDING PERMIT IIOAgD OF HEAI. TH 3 SETS OF PL,,I~IS ....... SURVEY ................ CIIE'CK ..... NOTi P'! ~ CALL ................. HAIL TO; Date .·.;...: .......... , 19.. INSTRUCTIONS a. 'Tkis apl~lication must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with sets of plans, accurate plot plan to scale. Fee according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public sti'ee or areas, and giving a detailed description of layout of property mu~t be drawn on the diagram which is part of this app cation. ', ¢. The work covered by tkis application may not be comm4nced before issuance of Bui/ding Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such perm ~hall be kept on the premises available for inspection throughout the work. ' e. No building shall be occupied or used ~n whole or in part for any purpose whatever until a Certificate of Occupanc shall have been granted by the Building Inspector. . .. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to th Building Zone Ordinance of the Town of Seuthold, Suffolk County, New York, and other applicable Laws, Ordinances o Regulations, for the construction of.buildings, additions or alterations, or for rem.evil or demolition, as herein describdc The applicant agrees to comply with all applicable laws, ordinances, building cgd~,/ho, u4ffi~d'e, and regulations, and t, admit authorized inspectors dy pTimises and in building for necessary i~.__~_~ --..-,7., ....... ,. ,' ; . (~n~2i-ureoFapp. licant, ori~ame, if a corporation) State whe'therXapphcant ~s' owner, lessee, 'agent, architect, engineer, general contractor electrician, plumber or builder. Name of owncr o£ premises ............. ~. . .~/~?/e'~J ' · (as on the tax roil or latest deed) If applicant is a corporation, signature o£ duly authorhed officer. (Name and title of corporate officer) . Builder's License No ................. ' ......... Plumber's License No ....... ~ ........ . ......i... Electrician's License No ....................... Other Trade's License No ...................... Location of land on which proposed work will be done ................................. ~ ................ lIouse Nmn ber Street Hamlet Connty Tax Map No. lO00 Section; ' ~ Block g4 : ' Lot Subdivision ff~C~ ff/O~5 ' Filed Map No. 40Z ( (Name) · · · · Lot ~,3 ......... Sla.[c existing use and occupancy of premises and in[ended use and occupancy of proposed construction: a. Existing use and occupancy .. ' ' b. Intended Use and occupancy ... O~ .~,~4,~ ~'U~ b ~ ~::~ ..... · 3. Nature of work (check whichlapplicable): New Building ........... .\ddition . Alteration Repair .............. RehqOval . ' ........ I ......... Demolition Other Work d C ,,q/~W ~-~ (Des:ription 4. Estimate cst ........ ! .......................... Fee ................ ) · , (to be paid on Rling this application) 5. lfdwelbng, number ofdwellin', un ~ . If garage, number of cars . [ ......... . tuber of dwelhng umts on each floor.. If ' · . ' ........................... ' ............ 6. bu~lllCss, commerclalormlxedoccmancv Snccif--~* ...... , - / .................... , ,- ., ~- ~ ,,.~u.u anu eXteut Gl.tach typo o ............ 7. Dimensions of existing structures, if any: f uso ............. , Front ..... Rear ...... Height ..... ~ ......... Nu~m bet of Storics ..... ~ ......................... Depth .............. me structure with alterat ' ' ' ' ..... u ........................ Dimensions ofsh ions or additions: Front ........ D pth ; i ................. Rear .......... e ...................... Height ................. ; · · Numb~rofStories ....... ' '~ "' 8. mens ohs o entire new cons ruction: Front ............. R De ....... ' Height ............... Nu0~ber of Stohes .... ear ............... pth ........ 9. Size of lot: Front .......... ~ · ' ............. fP ...... pth ...... Date o urchase .......... ~ ......... . ..... Name o Omer Owner . II ~ di ' · '' fF .......... . Zone or u e strict in which p~em~ses are situated.. ' .......................... ... . ocs proposed construcnon v ate any zoning law, ordinance or regulatio : .. 13 Will . ' ' ' ' Will fill b 0 .......... ' ' 14 N~ fO fp y · lot be regraded ...... ~ ................... excess e rem red from premises: es c · e o wrier o remises .. } ........ , ........ Address .... Nm fa '. ............... Phone No ........ : . e o rchitect ........ + ................. Address ...... ' ' ' N~e of Contractor ....... ~ .... ' ............ Phone No ............ ty BOO ............. Address ............. Phone No .......... 15 Is thi~i~roper within feet of a tidal wetland? *Yes ........ No ......... yes,~Southoid Town Trustees Permit may be required. · ". i PLOT DIAG~ Locate clearly ~d distinctly file build~gs, ~heth~r existing or proposed, ~d, indicate fil set-back d~ensions ft~m prope~y ~nes. Give street ~d block ~umber or description accord~g to deed, and show street nines and indicate whether ~tehor or corner lot. I ' 765-1802 9 AM ~ 4 PM FOR THE . ' FOLLOWING ,INSPE~ONS: FOR MOURED CONCRETE 3. INSULATION 4~ VINAt, CONSTRUCTION MUST BE COMPI..E~E FOR CO, a[,l~ CpNS'mOCrtON SHALL MEET THE REQUIREMENTS OF THE NY, ,S~TE CONSTRUCTION ,& ENERGY ' ;. {~?~.:S, NOT RESPONS BLE FOR 17~F~K;N OR CONSTRUCTION ERROR~ :ou ¥ ........ s.s ........ '.' ..... /.L.. ... (Name of individual signinglcontract) being duly sworn, deposes and says that he is the applicant 5ore named. · I Ontractor, agent, corporate officer, etc.) said Owner or owners, and is duly aut mazed to perform or have performed the said work and to make and file this plication; that all statements contained in this application are true to thelb8st of his knowledge and belief; and that the )rk will be performed in the manner se/forth in the application filed therewith. .'om to before me this ....... c;~~'''~ ' day of '!/~.~.t'/~7z~- ' ~'~' Notary Public, State of New Yore r ' ' '